Contrastive Sdtudy Of Different Operation Methodsin The Treatment Of Pediatric Ureteropelvi Junction Obstruction

Objective: To compare the security and its clinical efficacy of open Anderson-Hynes pyeloplasty,minimally invasive openpyeloplasty and traditional laparoscopic pyeloplasty in the treatment of pediatric ureteropelvic junction obstruction.Methods:Clinical data of 204 cases of UJPO treated with surgery in our hospital from February 2012 to August 2018 were retrospectively analyzed.The patients were used three different methods to treat,including Anderson-Hynes Pyeloplasty group(OP,143 cases),Minimally Invasive Open Pyeloplasty group(MIS,27 cases),and traditional laparoscopic Pyeloplasty group(CLP,34 cases).We Compared the age,gender,lesion area,body mass index,preoperative renal pelvis average diameter,preoperative glomerular filtration rate,operation time,intraoperative blood loss,hospitalization days,the start of oral feeding,average diameter after renal pelvis after operation,postoperative glomerular filtration rate,the pathologic types and postoperative complications.Data analysis was performed by using SPSS16.0,then adopted one-way ANOVE and chi-square.A P value of< 0.05 was considered statistically significant.Results: 1.The three groups of preoperative data were compared: age,gender,lesion area,body mass index,preoperative renal pelvis average diameter and preoperative glomerular filtration rate comparison difference has no statistical significance(P > 0.05).2.Intraoperative data in the three groups were compared.(1)In the aspect of average operation time,the CLP group was longest,which spent(235.35±54.9)min,the MIS group was shortest,which spent(94.64 ±35.97)min.the OP group times in the middle,which spent(112.11 ± 35.15)min.There are significant difference among the three groups(P<0.01).(2)In the terms of average intraoperative blood loss,the OP group was(13.93±12.56)ml,the MIS group was(11.07±4.62)ml,the CLP group was(11.70±7.87)ml.There are no statistically significant differenceamong the three group(P > 0.05).3.Postoperative data in the three groups were compared.(1)In the aspect of the start of oral feeding after surgey,the MIS group was(1.96± 0.64)d,the CLP group was(2.21 ±1.02)d,and the OP group was(2.36±0.73)d.The MIS group was the shortest in the three group.There are significant difference among the three groups(P < 0.05).the CLP group compared with the OP group has no statistical significance(P>0.05).(2)In the terms of hospitalization days,OP group was(8.24±4.98)d,the CLP group(6.18±1.42)d,and the MIS group was(5.48±1.19)d.The OP group is longer than the other group.There are significant difference among the three groups(P < 0.05).while the MIS group was shorter than the CLP group,but there has no statistical significance(P>0.05).(3)As to average diameter after renal pelvis after operation,postoperative glomerular filtration rate,the pathologic types and postoperative complications,the figure shows that there are no statistically significant difference among the three group(P > 0.05).Conclusion: 1、OP,MIS and the CLP has no significant difference of the clinical curative effect and safety in treatment of congenital ureteropelvic junction obstruction.2、Compared with the OP,the MIS and the CLP have some advantages.One advantage is shorter mean hospital stay and faster start of oral feeding after surgey.The other is smaller operative incision and better cosmetic results.3、When compared with CLP,the MIS has more strict indications and hard to get extensive application.The CLP operation has slight limitation and can be more widely used.4、In conclusion,CLP may be consider the first choice for the treatment of ureteropelvic junction obstruction;It is also recommended if the MIS has indicator,and the OP is not recommended.